Orthopedic prostheses are commonly utilized to repair and/or replace damaged bone and tissue in the human body. For example, a knee prosthesis can be used to restore natural knee function by repairing damaged or diseased articular surfaces of the femur and/or tibia. Knee prostheses can include a femoral component implanted on the distal end of the femur, which articulates with a tibial component implanted on the proximal end of a tibia to replicate the function of a healthy natural knee.
Osteoarthritis, a degenerative joint disease initiated through the loss of articular cartilage, can necessitate a knee replacement. A number of causes, including hereditary, lifestyle, mechanical deficits, and others, can lead to osteoarthritis. Knee prostheses can be used to restore the knee to the natural or anatomical alignment, including restoring natural constitutional varus, or to mechanical alignment where the yarns or valgus is corrected, referencing the long axis of the tibia, often including a series of soft-tissue manipulations.
The present inventors recognize, among other things, an opportunity for improved patient satisfaction following a total knee arthroplasty (TKA) through the use of a kinematically aligned TKA and surgical instruments to aid in the procedure. In particular, the inventors recognize the importance of improving the accuracy and repeatability of the steps in a TKA procedure in order to, among other things, improve patient comfort and functionality.
The knee is a complex joint, and accurate placement of the prosthetic knee components is one of several goals of knee replacement surgery. Recently, prosthetic knee implant systems have been introduced with additional sizes in efforts to more closely match the wide variety of patient sizes. The additional size options increases the need for even more accurate placement of the prosthetic components. Having additional prosthetic component sizes, with smaller shifts between those sizes can only be best appreciated with more accurate placement. In addition, accurate placement of the components relative to patient-specific anatomical origins has been reported to lead to improved patient function and satisfaction. Accordingly, in efforts to improve patient satisfaction after total knee replacement surgery, and consistent with the latest prosthetic component designs and additional sizes offered, there is a need for accurate, repeatable, easy to use, cost-effective, multi-functional instruments and surgical methods.
To further illustrate the systems and methods disclosed herein, following non-limiting examples are provided:
Example 1, a multi-purpose measurement tool comprises: an elongate beam extending from a first end to a second end, the elongate beam comprising a first fixed jaw extending from the beam at the first end; a second fixed jaw extending from the beam opposite the first jaw and spaced from the first end; and a track extending across the elongate beam through the first end; and a slide having a first end extending from the track and a second end extending into the track, the slide having a moveable jaw extending from the slide opposite the first fixed jaw; and the slide having a front face and a back face, each face with readable measurement indicia thereon.
Example 2 can include, or can optionally be combined with the subject matter of Example 1, to optionally include an elongate beam comprising a plate portion; a first rail extending from the plate portion to define a first side of the track and a portion of the first fixed jaw; and a second rail extending from the plate portion to define a second side of the track and a portion of the second fixed jaw; wherein the slide with the moveable jaw slides in the track defined by the first rail and second rail of the plate portion; and wherein the plate portion, the first rail and the second rail define an outer perimeter of the elongate beam.
Example 3 can include, or can optionally be combined with the subject matter of Examples 1 or 2, to optionally include a track extending along a major axis of the beam and the jaws extend transverse to the major axis.
Example 4 can include, or can optionally be combined with the subject matter of Examples 1, 2 or 3, to optionally include a plate portion that is transparent.
Example 5 can include, or can optionally be combined with the subject matter of Examples 1, 2, 3 or 4, to optionally include a slide including first indicia indicating a scale on a first side in a first orientation; and second indicia indicating the scale on a second side in a second orientation opposite the first orientation.
Example 6 can include, or can optionally be combined with the subject matter of Examples 1, 2, 3, 4 or 5, to optionally include a second fixed jaw that is spaced from the first end a distance equal to a width of the moveable jaw.
Example 7 can include, or can optionally be combined with the subject matter of Examples 1, 2, 3, 4, 5 or 6, to optionally include a second end of the elongate beam includes a level indicator.
Example 8 can include, or can optionally be combined with the subject matter of Examples 1, 2, 3, 4, 5, 6 or 7, to optionally include a level indicator comprising a bubble.
Example 9 can include, or can optionally be combined with the subject matter of Examples 1, 2, 3, 4, 5, 6, 7 or 8, to optionally include a level indicator being is selected from the group consisting of a roller ball, a plumb bob, or an accelerometer-based level indicator.
Example 10 can include, or can optionally be combined with the subject matter of Examples 1, 2, 3, 4, 5, 6, 7, 8 or 9, to optionally include a level indicator that indicates a level reading when the elongate beam is disposed at forty-five degrees from horizontal.
Example 11 can include, or can optionally be combined with the subject matter of Examples 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10, to optionally include an attachment including the level indicator.
Example 12 can include, or can optionally be combined with the subject matter of Examples 1, 3, 4, 5, 6, 7, 8, 9, 10 or 11, to optionally include a second end of the elongate beam that is configured to receive the attachment and includes a connection to immobilize the attachment.
Example 13 can include, or can optionally be combined with the subject matter of Examples 1, 2, 3, 4, 5, 6, 7, 89, 10, 11 or 12, to optionally include a first fixed jaw and moveable jaw that comprise a thickness gauge.
Example 14 can include, or can optionally be combined with the subject matter of Examples 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 or 13, to optionally include a second fixed jaw and first end of the elongate beam that comprise a depth gauge.
Example 15 can include, or can optionally be combined with the subject matter of Examples 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13 or 14, to optionally include a slide that includes a thumb grip.
Example 16 can include, or can optionally be combined with the subject matter of Examples 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14 or 15, to optionally include a first side of the elongate beam from which the first fixed jaw extends includes a fixation device for immobilizing the slide relative to the elongate beam.
Example 17 can include, or can optionally be combined with the subject matter of Examples 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15 or 16, to optionally include a second side of the elongate beam that includes ergonomic grips.
In Example 18, a method of using a multi-purpose measurement tool during a total knee arthroplasty comprises: measuring a natural anterior-posterior offset of a tibia from a femur using a second side of a tool; measuring distal femoral resections using a first side of the tool; measuring posterior femoral resections using the first side of the tool; and measuring an anterior-posterior offset of an implanted prosthetic tibia from an implanted prosthetic femur using the second side of the tool.
Example 19 can include, or can optionally be combined with the subject matter of Example 18, to optionally include using a level device attached to the tool to evaluate an angular relationship between the femur and tibia; and measuring the natural and implanted anterior-posterior offsets when the femur and tibia are disposed at a predetermined angular relationship to each other as indicated by the level device.
Example 20 can include, or can optionally be combined with the subject matter of Examples 18 or 19, to optionally include a predetermined angular relationship that is ninety degrees to each other.
Example 21 can include, or can optionally be combined with the subject matter of Examples 18, 19 or 20, to optionally include separating a level device attached to the tool from the tool; placing the level device in engagement with a drill guide; using the level device to evaluate an angular relationship between the femur and tibia; and drilling a hole in the femur using a drill engaged with the drill guide when the femur and tibia are disposed at a predetermined angular relationship to each other as indicated by the level device.
Example 22 can include, or can optionally be combined with the subject matter of Examples 18, 19, 20 or 21, to optionally include a predetermined angular relationship that is 90 degrees to each other.
Example 23 can include, or can optionally be combined with the subject matter of Examples 18, 19, 20, 21 or 22, to optionally include the natural and implanted anterior-posterior offsets of tibia from the femur are measured using a sliding depth gauge extending from a first end of the tool.
Example 24 can include, or can optionally be combined with the subject matter of Examples 18, 19, 20, 21, 22 or 23, to optionally include the distal and posterior femoral resections are measured using a sliding thickness gauge extending from the first end of the tool.
Example 25, a system for performing a total knee arthroplasty comprises: a multi-function tool including a depth gauge for measuring an anterior-posterior offset between a tibia and a femur; a level indicator attached to the multi-function tool for providing an indication of an angular relationship between the tibia and femur while measuring the anterior-posterior offset; and a drill guide for aligning a drill bit with the tibia or the femur; wherein the level indicator is separable from the multi-function tool and mountable to the drill guide.
Example 26 can include, or can optionally be combined with the subject matter of Example 25, to optionally include a thickness gauge and the depth gauge.
Example 27 can include, or can optionally be combined with the subject matter of Examples 25 or 26, to optionally include a thickness gauge and a depth gauge that share a common slide.
Example 28 can include, or can optionally be combined with the subject matter of Examples 25, 26 or 27, to optionally include a level indicator that provides an indication of an angular relationship between the tibia and femur while using the drill guide.
Example 29 can include, or can optionally be combined with the subject matter of Examples 25, 26, 27 or 28, to optionally include a drill guide comprising a stabilizer configured to lay across the tibia or the femur; a drill bit sleeve extending from the stabilizer and configured to guide a drill bit; and a handle extending from the drill bit sleeve.
Example 30 can include, or can optionally be combined with the subject matter of Examples 25, 26, 27, 28 or 29, to optionally include a stabilizer including a feature for engaging a feature of the level indicator such that the level indicator can be removably attached to the stabilizer.
Example 31 can include, or can optionally be combined with the subject matter of Examples 25, 26, 27, 28, 29 or 30, to optionally include the multi-function tool and the level indicator include engagement features for removably attaching the level indicator to the multi-function tool.
Example 32 can include, or can optionally be combined with the subject matter of Examples 25, 26, 27, 28, 29, 30 or 31, to optionally include a level indicator including a body comprising a first edge upon which a level indicator device is disposed; a second edge for mating with the stabilizer; and a third edge for mating with the multi-function tool.
Example 33 can include, or can optionally be combined with the subject matter of Examples 25, 26, 27, 28, 29, 30, 31 or 32, to optionally include a first edge that is disposed at forty-five degrees to both the second edge and the third edge.
In Example 34, the system or method of any one or any combination of Examples 1-33 can optionally be configured such that all elements or options recited are available to use or select from.
These and other examples and features of the present systems and methods will be set forth in part in the following Detailed Description. This Overview is intended to provide non-limiting examples of the present subject matter—it is not intended to provide an exclusive or exhaustive explanation. The Detailed Description below is included to provide further information about the present systems and methods.